Intraductal Papillary-Mucinous Tumors of the Pancreas

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Abstract
INTRADUCTAL PAPILLARY-mucinous tumors of the pancreas (IPMTs), recently defined by the World Health Organization (WHO),1 are characterized by the dilation of the main and/or branch pancreatic ducts and, occasionally, by the presence of mural nodules (papillary excrescences or protuberances) within the dilated pancreatic ducts. The IPMTs are frequently classified into 3 subtypes on the basis of the site of tumor involvement: main duct type, branch duct type, and combined type with both main and branch duct lesions.2 These intraductal lesions with a malignant potential are graded according to the WHO classification as adenoma, borderline, carcinoma in situ, and invasive carcinoma.1 Appropriate management of IPMTs requires the differentiation between premalignant and malignant lesions,2 but preoperative assessment fails to predict neoplasm extension in up to 40% of cases.3 Recent studies3-6 have demonstrated that poor survival after surgery is highly related to the presence of invasive carcinoma. An analysis of macroscopic features of IPMT in a retrospective study of resected pancreatic specimens may help in the correct prediction of invasive carcinoma.